Individual
DR. JORDAN ANDREW SHEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 GLENDALE DR W, WILSON, NC 27893-2770
(252) 399-7557
Mailing address
1924 ALCOA HWY # U-11, KNOXVILLE, TN 37920-1511
(865) 305-9230
(865) 305-8894
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2021-02023
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
TN
Other
Enumeration date
04/12/2016
Last updated
08/24/2021
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